Klonopin and Ativan

[Cmarm]

Hello I have read several of your posts on these medications. I read that medications peak at 2-4hr (about) and klonopin transfers at 2.8 percent into breast milk. I switched to Ativan since the half life is shorter compared to klonopin (I have epilepsy and severe anxiety and have been taking klonopin for 8 years along with keppra) but my question is, are these medications, klonopin and Ativan similar to when someone drinks alcohol? The question is, does is go in and out of breast milk like alcohol? Or does it stay there at that percentage. I am lucky enough to get about 8 hours of sleep every night (my husband watches the baby at night). He is only 3 weeks old (exclusively breastfed) and my dose is 1mg of Ativan at night (that was the new dose that was given to me) or 2mg of klonopin once during the day. I’m having even more anxiety taking the medication thinking my baby might have some sort of adverse reaction. I would really like to go back to the 2mg of klonopin once a day instead of the 1mg of Ativan. He hasn’t shown any reaction to Ativan but I do take it at night and he drinks expressed milk at night instead of being breastfed by me so I’m wondering if the amount he gets is out of my breast milk or he has been drinking milk with small amounts of Ativan this whole time and I’ve been worrying like crazy for nothing. Also is me switching back to 2mg of klonopin too much for a baby this young? Thank you so much for your time.

[admin]

Cmarm:

Both of these drugs are fine with breastfeeding as long as you don't exceed these doses. As long as he doesn't show any symptoms to sedation quite worrying about it an enjoy your infant.

Tom Hale Ph.D.

[Kim2020]

Dr Hale, I want to know about pregabelin. I take 200mg for chronic pain, and 25mg amitryptyline. I want to stop pregabelin even though I think it helps my debilitating nerve pain because of it passing into milk and I’m worrying about my 3 week old baby. Would duloxetine be a better choice of medication to take while breastfeeding? Thanks

[admin]

Kim:

sometimes it better to keep the mom healthy and comfortable if needed, and risk exposing the infant to a little drug. The dose of pregabalin in milk is low, less than 7.18% of the maternal dose. This is not enough to affect the infant. Same for amitriptyline, levels in milk are really low (1-2.8%) of the maternal dose.

Thus, I'd suggest you speak with your obstetrician before you stop your drugs IF they are working for you.

Tom Hale Ph.d.